In Dense Breasts, Screening Ultrasounds Find More Cancers

Screening ultrasounds plus mammography may find more cancers in women who have breast dense tissue.

Editor's Note: An earlier version of this article stated that ultrasound screening for women with dense breasts results in fewer false positives. However, screening ultrasound increases the number of false positive biopsies. The article has been corrected.

Ultrasound screening for women with dense breasts detects a small number of additional cancers, compared to screening mammography alone, at the expense of a significant number of additional false positive biopsies, according to an article published in the American Journal of Obstetrics & Gynecology.

Researchers from the University of Washington in Seattle performed a comprehensive literature review of studies regarding breast cancer screening of women with dense breast tissue in the United States published from January 2000 and April 2013. Of 189 peer-reviewed publications, the researchers found 12 studies that fit their criteria.

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The findings showed that when ultrasound was used in addition to mammography, physicians found an additional 0.3 to 7.7 cancers per 1,000 examinations (median 4.2) than when mammography was performed alone. There were also an additional 11.7 to 106.6 biopsies per 1,000 examinations (median 52.2).

“Most of the breast cancers identified by adjunctive US were small in size and node-negative in stage,” the authors wrote. “These are the cancers that are potentially curable by early detection and amenable to less aggressive treatment.” The researchers did point out, however, that some of the earlier staged cancers may have remained stable and been detected during the next regular screening mammography.

The researchers concluded that physicians should discuss with their patients how dense breast tissue can be a risk factor for breast cancer and whether the use of adjunctive screening, such as ultrasound, in addition to mammography screening may be beneficial for the patient.

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